Pragmatic disorders: An overview

Pragmatic disorders can be a significant barrier to effective communication for many children and adults. Yet, their characterization is often unclear and misleading, leading to misidentification of pragmatic language impairments. In this chapter, pragmatic disorder is characterized in terms of points of breakdown in the human communication cycle. Pragmatic competence is represented as a wide-ranging rational capacity that guides the production and interpretation of utterances. When this competence is impaired or does not develop along normal lines, pragmatic disorders of varying severity are the result. The chapter examines how these disorders are manifested in four clinical conditions: autism spectrum disorder; traumatic brain injury; right-hemisphere damage; and dementias. Linguistic data from children and adults with these conditions are analysed. The role of cognitive deficits, particularly theory of mind impairments, in pragmatic disorders is increasingly acknowledged. The chapter concludes by examining theoretical accounts of theory of mind and addressing how these accounts might contribute to an understanding of the type of mental state attribution that is essential to utterance interpretation in individuals with pragmatic disorder.